Association of Thyroid Hormone Therapy with Mortality in Subclinical Hypothyroidism: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 106 (1) ◽  
pp. 292-303
Author(s):  
Carol Chiung-Hui Peng ◽  
Huei-Kai Huang ◽  
Brian Bo-Chang Wu ◽  
Rachel Huai-En Chang ◽  
Yu-Kang Tu ◽  
...  
Keyword(s):  
Older Adults ◽  
Thyroid Hormone ◽  
Hormone Therapy ◽  
Subclinical Hypothyroidism ◽  
Data Extraction ◽  
Meta Analysis ◽  
Protective Effects ◽  
Random Effects Models ◽  
Meta Analyses ◽  
The Impact

Abstract Context Benefits of thyroid hormone therapy on mortality in adults with subclinical hypothyroidism remain undetermined. Objective To summarize the impact of thyroid hormone therapy on mortality in adults with subclinical hypothyroidism. Data Sources PubMed, Embase, Scopus, Web of Science, and Clinicaltrials.gov from inception until April 25, 2020. Study Selection Studies comparing the effect of thyroid hormone therapy with that of placebo or no therapy in adults with subclinical hypothyroidism on all-cause and/or cardiovascular mortality. Data Extraction Two reviewers independently extracted data and performed quality assessments. Random-effects models for meta-analyses were used. Data Synthesis Five observational studies and 2 randomized controlled trials with 21 055 adults were included. Overall, thyroid hormone therapy was not significantly associated with all-cause (pooled relative risk [RR] = 0.95, 95% confidence interval [CI]: 0.75-1.22, P = .704) or cardiovascular (pooled RR = 0.99, 95% CI: 0.82-1.20, P = .946) mortality. Subgroup analyses revealed that in younger adults (aged <65-70 years), thyroid hormone therapy was significantly associated with a lower all-cause (pooled RR = 0.50, 95% CI: 0.29-0.85, P = .011) and cardiovascular (pooled RR = 0.54, 95% CI: 0.37-0.80, P = .002) mortality. However, no significant association between thyroid hormone therapy and mortality was observed in older adults (aged ≥65-70 years). Conclusions Use of thyroid hormone therapy does not provide protective effects on mortality in older adults with subclinical hypothyroidism. However, thyroid hormone therapy for subclinical hypothyroidism may show benefits on morality in adults aged <65 to 70 years.

scholarly journals Leishmanicidal effects of resveratrol and its derivatives: a systematic review and meta-Analysis

2020 ◽  
Author(s):  
Nasrin Amiri Dashatan ◽  
Marzieh Ashrafmansouri ◽  
Mehdi Koushki ◽  
Nayebali Ahmadi
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Data Extraction ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Protective Effects ◽  
Random Effects Models ◽  
Important Health ◽  
Mean Differences ◽  
Meta Analyses

Abstract Background Leishmaniasis is one of the most important health problems worldwide. The evidence has suggested that resveratrol and its derivatives have anti-leishmanial effects; however, the results are inconsistent and inconclusive. The aim of this study was to assess the effect of resveratrol and its derivatives on the Leishmania viability through a systematic review and meta-analysis of available relevant studies. Methods The electronic databases PubMed, ScienceDirect, Embase, Web of Science and Scopus were queried between October 2000 and April 2020 using a comprehensive search strategy. The eligible articles selected and data extraction conducted by two reviewers. Mean differences of IC50 (concentration leading to reduction of 50% of Leishmania) for each outcome was calculated using random-effects models. Sensitivity analyses and prespecified subgroup were conducted to evaluate potential heterogeneity and the stability of the pooled results. Publication bias was evaluated using the Egger’s and Begg’s tests. We also followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for this review. Results Ten studies were included in the meta-analysis. We observed that RSV and its derivatives had significant reducing effects on Leishmania viability in promastigote [24.02 µg/ml; (95% CI 17.1, 30.8); P < 0.05; I2 = 99.8%; P heterogeneity = 0.00] and amastigote [18.3 µg/ml; (95% CI 13.5, 23.2); P < 0.05; I2 = 99.6%; P heterogeneity = 0.00] stages of Leishmania. A significant publication bias was observed in the meta-analysis. Sensitivity analyses showed a similar effect size while reducing the heterogeneity. Subgroup analysis indicated that the pooled effects of leishmanicidal of resveratrol and its derivatives were affected by type of stilbenes and Leishmania species. Conclusions Our findings clearly suggest that the strategies for the treatment of leishmaniasis should be focused on natural products such as RSV and its derivatives. Further study is needed to identify the mechanisms mediating this protective effects of RSV and its derivatives in leishmaniasis.

scholarly journals Prenatal maternal stress and risk of neurodevelopmental disorders in the offspring: A systematic review and meta-analysis protocol

2018 ◽  
Vol 1 ◽  
pp. 15
Author(s):  
Nicla Manzari ◽  
Karen Matvienko-Sikar ◽  
Franco Baldoni ◽  
Gerard W. O'Keeffe ◽  
Ali S. Khashan
Keyword(s):  
Systematic Review ◽  
Maternal Stress ◽  
Data Extraction ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Prenatal Maternal Stress ◽  
Cross Sectional ◽  
Increased Risk ◽  
Meta Analyses ◽  
The Impact

Background: Prenatal maternal stress (PNMS) is defined as the experience of significant levels of prenatal stress, depression or anxiety during pregnancy. PNMS has been associated with increased risk of autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) in exposed offspring. However, these findings are inconsistent and other studies found no association, meaning a clear consensus on the impact of PNMS on ASD and ADHD risk is required. The purpose of this systematic review and meta-analysis is to summarize and critically review the existing literature on the effects of PNMS on ASD and ADHD risk. Methods: Electronic databases (PubMed, PsycINFO, Web of Science, Scopus and EMBASE) will be searched for articles following a detailed search strategy. We will include cohort, case-control and cross-sectional studies that assessed maternal exposure to psychological and/or environmental stress and had ASD or ADHD as an outcome. Two reviewers will independently screen the titles, abstracts and full articles to identify eligible studies. We will use a standardised data extraction form for extracting data and a bias classification tool for assessing study quality. This systematic review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The generic inverse variance method will be used if possible to perform meta-analyses. Ethics and dissemination: Ethical approval is not required for this study because it will not involve the conduct or inclusion of any experimental or personal data that would require informed consent.  The systematic review will be disseminated in peer-reviewed journals. PROSPERO registration number: CRD42018084222.

scholarly journals Prenatal maternal stress and risk of neurodevelopmental disorders in the offspring: A systematic review and meta-analysis protocol

2019 ◽  
Vol 1 ◽  
pp. 15 ◽  
Author(s):  
Nicla Manzari ◽  
Karen Matvienko-Sikar ◽  
Franco Baldoni ◽  
Gerard W. O'Keeffe ◽  
Ali S. Khashan
Keyword(s):  
Systematic Review ◽  
Maternal Stress ◽  
Data Extraction ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Prenatal Maternal Stress ◽  
Case Control Studies ◽  
Increased Risk ◽  
Meta Analyses ◽  
The Impact

Background: Prenatal maternal stress (PNMS) is defined as the experience of significant levels of prenatal stress, depression or anxiety during pregnancy. PNMS has been associated with increased risk of autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) in exposed offspring. However, these findings are inconsistent and other studies found no association, meaning a clear consensus on the impact of PNMS on ASD and ADHD risk is required. The purpose of this systematic review and meta-analysis is to summarize and critically review the existing literature on the effects of PNMS on ASD and ADHD risk. Methods: Electronic databases (PubMed, PsycINFO, Web of Science, Scopus and EMBASE) will be searched for articles following a detailed search strategy. We will include cohort and case-control studies that assessed maternal exposure to psychological and/or environmental stress and had ASD or ADHD as an outcome. Two reviewers will independently screen the titles, abstracts and full articles to identify eligible studies. We will use a standardised data extraction form for extracting data and a bias classification tool for assessing study quality. This systematic review will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The generic inverse variance method will be used if possible to perform meta-analyses. Ethics and dissemination: Ethical approval is not required for this study because it will not involve the conduct or inclusion of any experimental or personal data that would require informed consent.  The systematic review will be disseminated in peer-reviewed journals. PROSPERO registration number: CRD42018084222.

Dietary patterns and depression risk in older adults: systematic review and meta-analysis

2020 ◽  
Author(s):  
Pei-Yu Wu ◽  
Kuei-Min Chen ◽  
Frank Belcastro
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Dietary Patterns ◽  
Data Extraction ◽  
Meta Analysis ◽  
Screening Tools ◽  
Inverse Association ◽  
Depression Risk ◽  
Study Heterogeneity ◽  
Meta Analyses

Abstract Context Diet may be one of the modifiable environmental factors that could reduce depressive symptoms or abate the development of depression without side effects. However, previous reviews mainly focused on general adult populations. Objective The aim of this systematic review and meta-analysis was to explore the association between healthy dietary patterns and depression risk in older adults. Data Sources Eight databases were searched up to September 2019. The inclusion criteria were older adults aged ≥ 65 years, healthy dietary patterns, depression assessed by a physician or by validated screening tools, and quantitative study design. Data Extraction Data were extracted independently by 2 researchers, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed. Data Analysis Meta-analysis was conducted by calculating the pooled odds ratio (OR) and 95% CIs. A total of 18 eligible studies were meta-analyzed. Results showed that a healthy dietary pattern is associated with a reduced risk of depression in older adults (OR, 0.85; 95%CI, 0.78–0.92; P &lt; 0.001). There was high heterogeneity (I2 = 64.9%; P &lt; 0.001) among the studies. Subgroup analyses indicated that sample size and depression screening tools were the main sources of study heterogeneity. Conclusions An inverse association between healthy dietary patterns and depression risk in older adults was found. However, the high heterogeneity among the studies should be considered. Systematic Review Registration PROSPERO registration no. CRD 42020169195.

The Impact of Financial Incentives on Physical Activity: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 089011712094013
Author(s):  
My-Linh Nguyen Luong ◽  
Michelle Hall ◽  
Kim L. Bennell ◽  
Jessica Kasza ◽  
Anthony Harris ◽  
...  
Keyword(s):  
Physical Activity ◽  
Financial Incentives ◽  
Leisure Time ◽  
Data Extraction ◽  
Meta Analysis ◽  
Random Effects Models ◽  
Walking Behavior ◽  
The Impact ◽  
Incentive Strategy

Objective: To evaluate the effects of financial incentives on physical activity (PA). Data Sources: MEDLINE, Embase, 7 other databases, and 2 trial registries until July 17, 2019. Study Inclusion and Exclusion Criteria: Randomized controlled trials with adults aged ≥18 years assessing the effect of financial incentives on PA. Any comparator was eligible provided the only difference between groups was the incentive strategy. Data Extraction: Two independent reviewers extracted data and assessed study quality. Of 5765 records identified, 57 records (51 unique trials; n = 17 773 participants) were included. Data Synthesis: Random-effects models pooling data for each of the 5 PA domains. Results: Financial incentives increase leisure time PA (gym or class attendance; standardized mean difference [95% CI], 0.46 [0.28-0.63], n = 5057) and walking behavior (steps walked; 0.25 [0.13-0.36], n = 3254). No change in total minutes of PA (0.52 [−0.09 to 1.12], n = 968), kilocalories expended (0.19 [−0.06 to 0.44], n = 247), or the proportion of participants meeting PA guidelines (risk ratio [95% CI] 1.53 [0.53-4.44], n = 650) postintervention was observed. After intervention has ceased, incentives sustain a slight increase in leisure time PA (0.10 [0.02-0.18], n = 2678) and walking behavior (0.11 [0.00-0.22], n = 2425). Conclusions: Incentives probably improve leisure time PA and walking at intervention end, and small improvements may be sustained over time once incentives have ceased. They lead to little or no difference in kilocalories expended or minutes of PA. It is uncertain whether incentives change the likelihood of meeting PA guidelines because the certainty of the evidence is low.

Meta-analysis of randomized trials to study the impact of prednisone on toxicities and survival in metastatic castration-resistant prostate cancer.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 28-28
Author(s):  
Gurudatta Naik ◽  
Charity Morgan ◽  
Matt D. Galsky ◽  
William K. Oh ◽  
Guru Sonpavde
Keyword(s):  
Prostate Cancer ◽  
Randomized Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Oral Prednisone ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Number Of Patients ◽  
Meta Analyses ◽  
The Impact

28 Background: The impact of daily oral prednisone (P) on toxicities and outcomes in men with metastatic castration-resistant prostate cancer (mCRPC) is unclear. We conducted a meta-analysis of randomized trials comparing regimens that included P in only one arm. Methods: PubMed, conferences and clinicaltrials.gov databases were searched for articles reported from January 1966 to June 2013. Eligible studies were selected in an unbiased manner and limited to randomized trials enrolling patients with mCRPC and comparing regimens administering P in only one arm. Data extraction was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Arms containing P were compared with arms without P for severe toxicities grade 3 or higher and overall survival (OS). Results: Five randomized trials were published or presented with P in only one arm: by Scher and colleagues comparing docetaxel (D) plus P versus D plus DN101 (n=953), by Higano and colleagues comparing DP versus GVAX (n=621), by Small and colleagues comparing DP versus GVAX plus D (n=394), by Fossa and colleagues comparing P versus flutamide (n=201) and by Petrylak and colleagues comparing mitoxantrone plus P versus D plus estramustine phosphate (n=770). The total number of patients was 2,939, of whom 1,471 received therapy not containing P and 1,468 received therapy containing P. All five trials were eligible for analysis of toxicities, but the Fossa trial was excluded for the OS analysis due to lack of required parameters. There was no difference between the non-P and P groups for severe toxicities (incidence rate ratio [IRR] = 0.82, p = 0.712, I2 = 97.9%). When examining toxicities as a reason for discontinuing therapy, the non-P groups were not different from the P groups (relative risk [RR] = 1.24, p = 0.413, I2 = 86.8%). The non-P groups demonstrated no difference in OS compared to the P groups (HR = 1.09, p = 0.531, I2= 79.7%). The meta-analysis is limited by the trial level design and small number of patients and does not exclude a favorable palliative impact of P. Conclusions: This meta-analysis of randomized trials in mCRPC suggests no significant impact on severe toxicities and OS with the use of daily oral prednisone.

Association of Thyroid Hormone Therapy with Mortality in Adults with Subclinical Hypothyroidism: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Huei-Kai Huang ◽  
Carol Chiung-Hui Peng ◽  
Brian Bo-Chang Wu ◽  
Rachel Huai-En Chang ◽  
Yu-Kang Tu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Thyroid Hormone ◽  
Hormone Therapy ◽  
Subclinical Hypothyroidism ◽  
Meta Analysis

scholarly journals Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism

2017 ◽  
Vol 376 (26) ◽  
pp. 2534-2544 ◽  
Author(s):  
David J. Stott ◽  
Nicolas Rodondi ◽  
Patricia M. Kearney ◽  
Ian Ford ◽  
Rudi G.J. Westendorp ◽  
...  
Keyword(s):  
Older Adults ◽  
Thyroid Hormone ◽  
Hormone Therapy ◽  
Subclinical Hypothyroidism

scholarly journals Non-adherence to immunosuppressants following renal transplantation: a protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e015411 ◽  
Author(s):  
Abigail Hucker ◽  
Frances Bunn ◽  
Lewis Carpenter ◽  
Christopher Lawrence ◽  
Ken Farrington ◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Transplant ◽  
Data Extraction ◽  
Meta Analysis ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Data Extraction Form ◽  
Registration Number ◽  
Meta Analyses ◽  
The Impact

IntroductionAdherence to immunosuppressant medication is essential for renal transplant recipients. This review aims to summarise what is known about non-adherence, with a view to providing comprehensive evidence to inform strategies aimed at advancing adherent behaviour.Methods and analysisA systematic review of quantitative studies that report adherence to immunosuppressants in adult (over 18 years) renal transplant recipients. The review will follow the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines; study quality will be assessed using the Downs and Black checklist. Systematic searches will be completed across relevant databases. Two reviewers will independently extract data using a predefined data extraction form. We will summarise the operationalisation of adherence across studies and use narrative synthesis to identify factors associated with non-adherence. A meta-analysis will be conducted if there is sufficient homogeneity, and available data, across studies to estimate the prevalence of non-adherence in renal transplant recipients. Heterogeneity will be assessed using the I2test. Survival analysis will be conducted to estimate hazard ratios to explore the impact of non-adherence on graft survival, graft failure and patient survival.Ethics and disseminationFindings will be published in a peer-reviewed journal and disseminated at conferences for professionals and researchers. Review outcomes will help support clinical practice by highlighting the extent of non-adherence among adults, and in doing so, signpost the need for suitable intervention.Trial registration numberPROSPERO registration number (CRD42016038751).

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